Organization
C. O. A. C. H. MENTAL HEALTH, LLC
Active
Organization
C. O. A. C. H. MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE T GREEN LCPC, NCC (OWNER/THERAPIST)
(443) 982-0692
Entity
Organization
Contact information
Practice address
1220A E JOPPA RD STE 230B, TOWSON, MD 21286-5822
(443) 982-0692
(410) 616-9294
Mailing address
1220A E JOPPA RD STE 230B, TOWSON, MD 21286-5822
(443) 982-0692
(410) 616-9294
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH001372
—
MD
Enumeration date
02/27/2019
Last updated
09/22/2023
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